LISTS – AND LISTS
I know you are all looking for THE list. Here is one from a reliable source I have have downloaded on my site to a separate document so it opens with one click.
The reliable source, as it turns out, needed some updating. Dr Ross Holmes, professor, School of Medicine, University of Alabama, was kind enough to review the work of Dr. Michael Liebman who is a professor of Human Nutrition and Food Option at University of Wyoming and determine which food entries on the Harvard list needed changing. We cannot change the original but we have updated our lists accordingly and annotated updates with *** marks. So the lists here are the most recently edited available at present.Fred Coe and I have updates and annotated the list for those with a tendency to perfectionism: Updated table of oxalate foods. Set it at 50% for easier reading. Get yourself acquainted with the lists. They will tell you much of what you need to know. A lot of it will even surprise you. You are not as restricted as you think you are or as you have been told.
A more dramatic list is the 177 high oxalate foods we distilled out of the big list. Here are culprits! Not on this list? Probably not very high in oxalate so far as we know – with perhaps a few exceptions. Note that quantity is critical. For example black pepper is high in oxalate but the amounts used are small enough that total oxalate intake from it is negligible.
Eating a low oxalate diet can be overwhelming and difficult to incorporate into your daily life. I just released a course called The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.
LET’S DIVIDE AND CONQUER
FOODS TO WORRY ABOUT
A List of Concerning Foods
We have created two graphs for this article. Of the 177 foods on our master list, many are of concern but can be used in your diet if you control the portion size and how often you use them. There are 30 of them that are worrisome enough to deserve special attention.
Here are the 30. The graph shows mg of oxalate in a common portion. The details of the portions are in the complete list. The foods have in common that all contain at least 40 mg/serving. All other foods for which we have reliable data have less oxalate per serving.
Your budget is about 100 mg/day.
What does this graph mean? Does it mean you can never have chocolate, or a baked potato?
No.
It means if you want to use your whole budget on a treat, do it, but keep track and make sure you do not overspend in any meal or in any one day. Have your baked potato, but maybe share half with your partner. Or, have some hot chocolate but make it with milk because calcium helps reduce oxalate absorption. Eat your cashew nuts, but pay attention to how many. If one handful leads to ten, you cannot have them.
FOODS TO AVOID
The graph to the left is of the very few dangerously high oxalate foods.
There are only six foods, but spinach, being worst of all, has two entries. Be careful of this plot because of its range. It begins at 100 mg/portion and rises to 755 mg/portion in only 7 steps, so the distance from miso soup to spinach is about a 7 fold increase.
Rhubarb and spinach are so high you just cannot eat them. Rice bran is something few will miss, the same for buckwheat groats.
People like almonds but have a hard time controlling portion size. If you can keep it to 11 almonds a day – the portion size that gives 122 mg of oxalate, alright. Otherwise stay away from them.
If you have to eat any of these foods, caution is hardly a strong enough word.
Are you sure you need to eat them?
Why?
WHAT ARE WE SAYING?
We are saying that oxalate is common in foods, and that you have to be careful, but care is a scarce resource. How much care can you give every bite? The graphs say if you eat moderately high oxalate foods – the first graph – be careful.
Watch portions.
If you are eating one of the six dangerously high oxalate foods, stop eating it.
It is too hard to be careful with those six foods. They have too much oxalate for most of you to handle. So, just say no.
WHY BELIEVE OUR DATA?
These data arose from a major effort at the Harvard School of Public Health. A world class expert has curated it twice. Harvard can be wrong and so can Ross Holmes, but both will tend to be wrong less often than the average persons who attempt to put complex data into the public domain. We have always appreciated comments, and if anyone has a peer reviewed publication with different food oxalate levels than ours, we will read the paper and see if it warrants our making a change.
Medical research is endlessly argumentative, and food oxalate is no exception. A recent paper contrasts findings from 6 websites and 2 applications and finds some wide variations. Of the sites, the Harvard site – used here as our reference, and the Wake Forest site – which is a legacy of an outstanding investigative group have most standing with me. Leaf through the comparisons between them in the 4 charts and in the large table at the very end. On the whole differences are modest. The hyperoxaluria and oxalosis list from the paper has been withdrawn from their site.
DO YOU NEED A LIST?
Sure, a list is nice. But we helping you here. Lists can run on to hundreds of foods. The picture is meant for focus. Here are the ones to focus on.
Many of you leave the doctor’s office thinking you will never be able to eat a fruit or vegetable again. If that wasn’t bad enough chocolate and nuts are gone, too. Some of this sadly is true, most of it is not. I am here to bring you good news: Almost everything, high oxalate or not, can be incorporated into your diet safely.
Do you need a low oxalate diet? You may if your stones contain calcium oxalate crystals and your urine oxalate is high enough to pose risk.
If you do need a low oxalate diet, what is your goal? Less than 100 mg of diet oxalate is good; less than 50 mg is ideal.
If you want to read some of the science about urine oxalate and risk of stones and about how we get to the diet oxalate goals, it is summarized at the end of this article.
Here we assume you do need to lower the oxalate in your diet.
CALCIUM FIRST
Low calcium diets can raise urine oxalate, and the solution may be as simple as a proper calcium intake. There is every reason for stone formers to eat 1000 mg of calcium daily to protect their bones. The common hypercalciuria of calcium stone formers puts bones at special risk when diet calcium is low.
Before changing your whole life around, ask yourself if you are avoiding calcium foods. If so, add them back and ask your doctor to check your urine oxalate again. It may fall enough that a low oxalate diet is not necessary.
If low calcium intake is not your problem, and you need a low oxalate diet, here is my take on how to do it.
WHAT IS THE DIET OXALATE GOAL?
Typical diets contain upward of 200 – 300 mg of oxalate. For stone prevention, a reasonable goal is below 100 mg of oxalate daily. An ideal would be about 50 mg daily if that can be accomplished.
To get there, consider the oxalate contents in common serving portions of all of the foods, and make up a plan for yourself.
FRUITS
FRESH
Everyone who comes to me is very unhappy thinking they can never have a berry again. This is Baloney. The only berry that is very high in oxalate is raspberries (look at the list). On the other hand, people do not realize avocado, oranges, dates, and even grapefruit and kiwi are very high and need caution.
This doesn’t mean you can never have these healthy treats. If you incorporate any of these high oxalate fruits into your morning yogurt you can reduce some of the effects of the oxalate content.
Also look at your portion sizes. You really cannot eat a lot at any one time. Dates are not a good bargain: One date is 24 mg!
CANNED OR DRIED
Canned pineapple is a problem.
Dried fruits have to be a worry because the water is taken out, so a ‘portion’ of dried fruit can be gigantic in oxalate content. Figs, pineapple and prunes are standouts. Just think: 1/2 cup of dried pineapple is 30 mg – not a lot of fruit for a lot of oxalate. If you want dried fruit, think about apples, apricots, and cranberry as lower oxalate options.
VEGETABLES
Spinach and rhubarb are standouts; stay away.
Other vegetables you need to be aware of are tomato sauce, turnips, okra, and yams (sweet potatoes) along with beans of different sorts.
I am not in the business of taking healthy foods away from people. But in the cases above you really must limit; there is just too much oxalate and these foods do not pair well with high calcium foods the way fruits can be mixed right into your yogurt or cereal and milk.
Many of you have been told to stay away from all green leafy vegetables. This is not true. Look at the list. There are plenty of salad options still available for you including kale. Even though tomato sauce is high in oxalate (see below) that is because of concentration. A whole medium tomato is only 7 mg and who eats more than one at a time?
Many of the salad vegetables are so low in oxalate they are freebies. Eat what you want.
POTATOES
These are Trouble! I put them into their own separate group even though they are vegetables.
From french fries to baked potatoes they are very high oxalate items. One ounce of potato chips has 21 mg of oxalate and who eats one ounce? Not I. Baked potatoes are terrible. One comes in at just under 100 mg of oxalate. Mixing sour cream into the potato will not help much; one tablespoon of sour cream contains only 14 mg of calcium. One ounce of cheddar cheese contains 200 mg of calcium, which could help, but it increases calories, salt and fat. But all in all, why struggle so hard? Potatoes are not ideal for stone formers.
DAIRY PRODUCTS
They have no oxalate. They are your main source of calcium. Use them. They can add a lot of salt – cheeses – and can be caloric. But they reduce oxalate absorption and preserve your bones.
For a stone former who has to watch salt intake, increase calcium intake, and lower oxalate intake, here is how to do that. You cannot have as much cheese as you want because of the salt. So portion sizes are very important. Yogurt, milk, even ice cream are good bargains – modest sodium and high calcium. These are a great place to add in a wee bit of chocolate – high oxalate foods – for those of you who cannot live without these high oxalate treats.
BREADS AND GRAINS
Some of the basic ingredients to make these foods are very high. White flour and brown rice flour are high in oxalate so everything you make from them will be high.
BREADS
Even so, as far as kidney stones go, breads are mainly alright because of portion size: not that much flour so one slice is 5-8 mg. French toast and New York style bagels top the list at 13 mg for two slices and 40 mg for one bagel – as much as anyone will eat of either food.
PASTA RICE AND GRAINS
Spaghetti, one cup cooked is 11 mg and most of us eat more than one cup.
Buckwheat groats, one cup cooked is 133 mg – I don’t see many of you saying ‘darn it’ or taking to your bed, but beware. Millet and bulger, wheat berries, rice bran, corn grits, and corn meal, these are widely used and are high. If you are using these, be thoughtful.
Here are some low oxalate options in this category: White rice, hummus, corn flour, corn bran, flax seed, and oat bran are popular and safe.
MEAT PRODUCTS
Since oxalate is only found in plant foods, all the meats are safe. Fish, too.
For our vegetarian friends, tofu and veggie burgers are very high.
NUTS AND SEEDS
These are just dangerous for two reasons.
Obviously they are very high in oxalate.
Secondly, I don’t know anybody who just has a few nuts at a time.
Just like chips no one eats one – the whole jar is more like it.
But, for one cup of pumpkin sunflower or flax seeds the highest is only 17 mg of oxalate and none for flax. For those of you who love foods in this category seeds are the better choice and they can be sprinkled on yogurt and ice cream.
SWEET STUFF
I have good news for my chocolate lovers. I know most of you have been sent home with a list and chocolate is high on it. But if you look at the numbers nuts are a lot worse than chocolate. Chocolate can be mixed in with dairy products, too, so as to reduce oxalate absorption.
Even so I do want to point out that half a brownie is on the high side, and who eats one half?
You can still satisfy your sugar craving but pay attention to your portion size.
Keep in mind, however, that sugar loads increase urine calcium loss which increases stone risk, so there are two reasons why this food group can be a problem.
But even without chocolate, you eat a lot of flour when you eat a piece of cake, so cake can be a problem – about 15 mg per piece, like french toast. Pies are half the risk because of their fillings – unless they are chocolate pies!
CRACKERS AND CHIPS
The big enemy here is potato chips. A one ounce serving contains a whopping 21 mg of oxalate. I repeat: A one ounce serving.
Your best bet in this category if you’re looking for something crunchy is corn chips – one ounce is 7 mg, popcorn – one cup is 5 mg, and pretzels, one ounce is 5 mg.
Crackers are OK mainly because they are small and the amount of flour is not that much.
BEVERAGES
PLANT SOURCES
Hot chocolate is the clear loser at 65 mg per cup; carrot juice is the runner up at 27 mg per one cup. Lemonade, tea, tomato juices, rice dream and the like are better but still high. The are 15 – 18 mg per serving. Lemonade – frozen concentrate – is 16 mg per 8 ounces so be careful about this as a source of citrate.
Soy milk, for those of you who prefer it, is not a good option. It is very high at 20 mg per cup. We have no data from standard sources for rice milk, cashew milk, and coconut milk; almonds are high in oxalate so the almond milk product will certainly be high.
Tea is so commonly used, here are the details. If you brew your own tea it is high in oxalate. The longer you steep your tea, the more oxalate it will have in it. If you use a sweetened instant iced tea one cup has 0 mg of oxalate.
Here are some juices that are low in oxalate and better substitutes: Apple juice, apricot juice, orange juice, grapefruit juice, grape juice. For all the lemonade drinkers, diet lemonade is low in oxalate.
Here is something very important: Coffee is oxalate free – almost, 1 mg for a cup (2 mg/cup for decaf). We already told you that coffee drinkers have a reduced stone risk, so lets debunk the coffee myth here: Drink it as you wish.
DAIRY SOURCES
Everything is good except chocolate milk. Even that is only 7 mg a cup for a sweet treat here and there.
ALCOHOL
What tops the list in this category is a can of beer: 4 mg of oxalate. All the rest are low and, frankly, the oxalate in a can of beer comes with a lot of fluid. This is not the problem area for stone formers.
WATER
If I didn’t say this to you I could not sleep well tonight. Water is the clear winner in this whole category. It is free of calories, sugar, and oxalate. Please use it as your main beverage and supplement with the items above.
SPREADS AND SAUCES
Chocolate, miso, peanut butter, and tahini are all high.
SOUPS
Miso soups is extremely high – 111 mg/cup. Lentil soup is high, and so is clam chowder – the potatoes.
BREAKFAST FOODS
This is a dangerous meal if you are a cereal lover. Many cereals are high in oxalate. I am afraid you need to look them up in the list by brand. Unfortunately the healthier cereals are highest in oxalate because they contain more plant based ingredients. Probably having milk in your cereal is wise, but we have no data to show.
Eating a low oxalate diet can be overwhelming and difficult to incorporate into your daily life. I just released a course called The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.
HOW DO WE MANAGE ALL THIS?
The first thing you need to do is to learn and remember what are the highest oxalate foods and beverages. Without this in mind it is impossible to shop and cook intelligently. Here is a short list of the highest oxalate foods all in one place.
BREAKFAST
For those of you who love cereal because it is quick and easy check out the list and see if the one you love is high in oxalate. If it is, choose the next best one with lower oxalate. Put milk in the cereal.
Alternatives to cereal that are also quick and easy: Yogurt or cottage cheese and fruit. The only fruits to worry about are raspberries because no one puts oranges on their yogurt. Bananas, peaches, blueberries and strawberries are perfect toppings.
More trouble, but no oxalate, eggs any way at all. Boil a batch on Sunday and have them for the week for breakfast, and snacks, too.
Your breakfast coffee is free and so is your water. For juices use orange, apple, pineapple, grapefruit – all great. If you want tea, don’t steep more than a minute and consider adding milk to it. Green tea is better than black.
LUNCH
Typically you are grabbing a salad or a sandwich for lunch, so what now? Many clients tell me they no longer eat salads because their physicians told them to stop all green leafy vegetables.
I’m bringing salads back to you.
Arugula, iceberg, romaine lettuces, and kale, are fine as your base. Stay away from spinach. Here are good toppings. Cauliflower, corn, cucumber, mushrooms, onions, peas, scallions, squash and zucchini are all fine. Tomatoes are fine, too; it is only the sauce that is high. Broccoli and green pepper are moderately high so watch the portion size.
Sandwiches will cost you between 12 and 16 mg of oxalate depending on the bread you are using – 2 slices. This doesn’t mean you can never have a sandwich, it just means you have to keep track of how much. You can have 50 to 100 mg daily. What goes inside between the two slices of bread is usually cheeses and meats which are oxalate free. So sandwiches are not something to be afraid of.
SUPPER
Beef, chicken and fish are all fine, and those the main courses for most of us. You will run into problems if you are a pasta or potato eater. If you are you need to limit the amount of times you have these foods each week and also the quantity each time you use them. Substitutes are a problem: White rice is a nice substitute for potatoes but there are few others. It is more veggies that have to fill in – very healthy but not as much fun.
Here is a recipe for cauliflower – ‘mashed potatoes’ you will like and even think, sometimes, is the real thing. There are many versions on the web, choose the one that makes you happy but be careful about the ingredients.
There is also quinoa which is not on our lists, but may well be high. A recent scientific article on this plant does not give oxalate contents which suggests they are not reliably known.
I have recently put together a private FB page called THE Kidney Stone Diet. It is a group that helps educate you on your physician prescribed treatment plans. As you can imagine, oxalate comes up in many posts. I moderate it to keep it clinically sound. Come on over and join the discussion!
URINE OXALATE AND RISK OF KIDNEY STONES
I promised you some science – here it is for those interested. It concerns only highlights from the food – urine oxalate research recently performed and seemingly germane to the problem of how stone formers should control oxalate intake.
The most useful data about urine oxalate we have so far is from three cohorts studied by Dr. Gary Curhan. Two are cohorts of nurses one a cohort of physicians. These people have kept track of many aspects of diet and health for decades, and among their records are onset of kidney stones.
As he did for urine calcium, Curhan measured urine oxalate in properly selected subgroups from each cohort, including people who did and did not begin forming stones. From these samples he could calculate the relative risk of new onset of stones in relation to 24 hour urine oxalate excretion.
The two nurse cohorts are red, the physicians – all men – are blue. The dotted line at 1 is the risk threshold: Above that line, risk is present.
The top of each crosshatched bar shows the mean relative risk for each of the five urine oxalate ranges. Clearly the mean goes up as urine oxalate goes up.
But the mean relative risk has a range of uncertainty around it. The bottom of the solid portion of each bar is the lower 95th percentile for that range of uncertainty. When that bottom lies above 1, risk is very likely to be present.
For both the women and men groups, that point is reached between 25 and 30 mg of urine oxalate a day. Therefore one wants to try to get urine oxalate below 30 mg daily and even lower, below 25 mg daily if possible. The average urine oxalate excretion among the women in this study was close – 26 and 28 mg/day for those who did not form stones and just a bit higher for those who did – 28 and 30 mg per day. The men are a problem: 39 and 41 mg/day for those who did not and those who did form stones.
This is not diet oxalate, it is urine oxalate. Urine oxalate is how much the body makes and how much is absorbed from foods. Mostly, we can control only the second part – how much is in the food.
HOW MUCH DIET OXALATE DAILY
All dietary advice depends on having a reasonable goal in mind for oxalate intake. My goal of 50 – 100 mg of oxalate from food daily is not unreasonable given the research that has been done in normal people and stone formers.
Holmes and colleagues found a urine excretion of oxalate of about 10 mg/gm urine creatinine in normal 
people eating a synthetic oxalate free high calcium diet (graph at left). As diet oxalate increased, urine oxalate rose from 0 to 10 mg/2500 kcal/d, urine oxalate rose steeply from 10 to 14 mg/gm urine creatinine. It rose more slowly, from 14 to barely 15 mg/gm urine creatinine as diet oxalate was increased to 50 mg/2500 kcal/d, and more or less at the same slope thereafter so that an increase from 50 mg/2500 kcal/d up to 250 mg/2500 kcal/d increased urine oxalate only from 14 to 18. The closed symbols are whole food the open symbols synthetic diets.
From this work the percent oxalate absorption could be calculated as around 10 – 15% and the contribution of diet oxalate to urine oxalate excretion as around 25 – 40% when intake of oxalate was between 50 and 350 mg/2500 kcal. Therefore one can consider a whole food 1000 mg calcium 50 mg oxalate as a usable low oxalate diet, and a 150 – 250 mg oxalate diet as relatively high.
The balance between diet calcium and diet oxalate does not matter greatly if diet calcium is high. Among normal men and women eating 1000 mg/day of calcium and 750 mg/day of food oxalate, 24 hour urine calcium was about 110 mg/day and oxalate about 44 mg/day.
If the calcium oxalate balance is altered so calcium intake is 400 mg and 20 mg of oxalate at breakfast and lunch, and 200 mg of calcium and 710 mg of oxalate at dinner, as compared with simply 333 mg of calcium and 250 mg of oxalate in all 3 daily meals, urine oxalate is lower after the high calcium low oxalate meals, but only slightly higher after the high oxalate low calcium evening meal than when calcium and oxalate intakes were balanced. This means that when diet calcium is at least 1000 mg daily the balance of calcium to oxalate within any one meal is not likely to affect stone risk.
Seiner and colleagues make clear that stone formers are different from normal people. They divided male and female stone formers into 2 groups of 93 people each, one with urine oxalate above 0.5 mmol (~50 mg) of urine oxalate daily and the other with urine oxalate below 0.4 mmol (~40 mg) daily. They found virtually identical calcium and oxalate intakes: 845 vs. 812 calcium and 101 vs. 130 mg daily of oxalate respectively in the lower and higher urine oxalate groups. But the below 0.4 mmol group excreted only 27 mg of oxalate daily on average, whereas the high oxalate group excreted 64 mg daily. In other words diet was not responsible for the higher urine oxalate excretion, suggesting a difference of oxalate absorption. Those prone to high oxalate excretion seem, therefore, to most need diet modification.
Knight and colleagues found a wide range of oxalate absorption among 38 calcium oxalate stone formers eating a self choice diet. Urine oxalate excretion (vertical axis) varied with percent of diet oxalate absorbed (horizontal axis). The mean absorption centered around 5%; a few outliers absorbed over 15% up to 25%. This supports what Seiner found – some stone formers will have urine oxalate levels very responsive to diet oxalate and sans a research protocol we will not know. This is another good reason to keep diet oxalate low – 50 to 100 mg if possible.
PROTEIN AND GELATIN
Diet protein intake does not affect urine oxalate excretion. In 11 normal people fed a 1000 mg calcium, 51 mg oxalate, 3000 mg sodium fixed diet, varying protein intake from 0.6 to 1.6 gm/kg/day – a very wide range – did not alter urine oxalate appreciably (mean values were 23, 23, and 25 mg daily for the three protein intakes) even though oxalate precursors like glycolate rose markedly (25, 22, and 46, mg daily).
Jello is a source of hydroxyproline which converts to glycolate and oxalate, and oral loading with gelatin can raise urine oxalate. Ten normal people eating a 1000 mg calcium, 150 mg oxalate diet (typical normal level) were fed supplemental gelatin as one quarter of daily protein intake. Urine oxalate was 24 mg daily vs. 17 mg daily when the same diet was supplemented with whey protein – containing little hydroxyproline – as a control. So lots of jello is not an ideal plan for stone formers.
Where does this leave us about how much oxalate is alright for a day. If diet calcium is high, as it should be, at about 1000 mg, then one should try to limit diet oxalate below 100 mg daily. Perhaps this is most important in those patients whose baseline oxalate excretions are higher – in the range of above 40 mg daily.
Eating a low oxalate diet can be overwhelming and difficult to incorporate into your daily life.
For those who need special help, I run an online course: The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.
Another point to get clarified on oxalate rich foods. Is it recommended to totally avoid them or eat them in moderation?
Hi Wally, Oxalate diets are a fine detail and not the main point in diet to prevent stones. Here is a better look at the kidney stone diet. Here is one concerning whether low oxalate diet matters in a given patient. Regards, Fred Coe
Good day,
we sometime get water from a desalination plant, is that a risk? apart from your list, I’ve been asked to avoid Jam and beef and pork meat.
Hi Ursula, The water does not seem a risk. As for prevention, you need a real plan with a rationale and jam, beef and pork do not quite do it. Here is the evaluation everyone needs. Here is the best diet for stone prevention. Regards, Fred Coe
The Harvard List, list Avocados as very high in Oxalate yet a comment above from Fredrick Coe, M.D. states:
Fredric Coe, MD
September 29, 2017
Hi Kristin, Cooking the oxalate will not alter it. “Avocado is not remarkably high in oxalate”– it is all about the portion size. But note that your dates have a lot of sugar in them. Even so sounds delicious; I doubt it will cause stones. But – be sure you have evaluated your condition; mere oxalate lists are nothing much. Prevention needs a lot more thought. Here is a good guide. Regards, Fred Coe
Portion size? What would be considered a good portion size if avocado is NOT remarkable high in oxalate but “IS”? Needless to say I am confused.
Hi Janine, Sorry for the confusion. Avocado is not remarkably high in oxalate, it is just that portion size can be high. Keep the amount to a few ounces per serving. Lists are amounts of oxalate per serving size. As for my other remarks. Do not reduce oxalate intake unless you need to. You need to if your stones are calcium oxalate, your urine oxalate is high enough to raise risk of stones (above 25 mg/day) and remains that high when you are eating a proper amount of calcium 1000 mg or more with your main meals. Usually enough calcium will lower oxalate enough that food restrictions become very modest. Finally, I noted your dates are very high in sugar and sugar is perhaps a bigger problem than oxalate – I did not express myself well here! Does this do it? Regards, Fred Coe
Would be helpful if you would date your list/article, as there are many such articles about oxalate diets on the web and many conflict, in part because of continuing research on the subject. I also have read in a few online articles (sorry I don’t have references handy) that the it is the soluble oxalate content of an item that makes it concerning, as they are eliminated via urine, not the total oxalate content; the insoluble oxalates are eliminated via solid waste, though they do bind to valuable nutrients in the intestines. From what I recall, cinnamon us a good example if this – it is high in total oxalates but very low in soluble oxalates, so is not a concerning food item. Does your “list” show mg of soluble oxalate content or total oxalates?
By the way, thank you for your post. There’s a lot here, and I’m still digesting it all, but I very much appreciate that your research and experience are available on the internet.
Hi Ross, For your own care, consider an approach like this one – oxalate is usually only a part of the problem. Regards, Fred Coe
Hi Ross, It would seem so, but not in reality. The list was taken from the Harvard source and curated by Professor Ross Holmes who is the leading US oxalate diet scientist. Any new material would be added as Ross found it given his attachment to the other scientists who work with food oxalate. There are not ‘many such’ articles about oxalate on the web. Most are faulty, derivative, or both. At least one is highly commercialized, unlike this one that originates at a university. The list does indeed show total oxalate, but the correlation between what is in the foods and what can be absorbed is good enough that higher levels of total oxalate translate into more absorbed. I notice you put ‘list’ in quotes. This site is not susceptible to sneer. I am an established NIH funded kidney stone investigator, Dr Holmes is, too. We adhere to the highest standards of data management and accuracy, and reference our articles to PubMed. You will not find that the case with many such articles. Regards, Fred Coe
Thank you for your reply. I respect the authority of the writings posted on this site, but I still feel as a matter of practice, information on the internet should be dated, so readers know how current the information is. What got me researching on the internet was that the oxalate food list my urologist gave me was dated 2003! Although it wasn’t the only thing he discussed with me regarding stone management, it was an important piece, so I wanted to ensure I was referencing the most current information available. Thank you for directing me to Chapter Three; I’m still reading through the linked articles, but everything I’ve read so far has helped put the many pieces together and into perspective. Thank you for taking the time to respond to the comments posted on the various articles; also very helpful.
I recently had a two week, miserable bout with kidney stones. After asking any Urologist how to prevent further problems, he told me about oxalates. I’ve researched food-type oxalate levels. Some lists contradict others. Is there a bone fide list of specific foods (e.g. apples, specifically my favorite, Macintosh) that is recommended? I’m keeping a list of oxalate-rich favorite foods to move from. Thanks.
Hi Jim, Your urologist told you only part of the story. Stone prevention is much more than a mere oxalate list, often it has little to do with oxalate per se. Here is a good beginning article. Here is one further down stream. Let me know if these help. Regards, Fred Coe
As I was looking at the first list mentioned in this article, I noticed several contradictions. Has anyone else noticed that? For instance, soy milk is listed twice and with conflicting oxalate categories. One is in “Beverages” and says “Very High”, which does have a star next to it, and the other is in “Dairy Beverages” and says “Low”, yet both portions are one cup. They also have two different oxalate values. Very strange.
Another issue is that Stevia is an Artificial Sweetener. So, why is it listed separately, and why aren’t all of the sweeteners listed if Stevia is listed? What makes it different since one is very low and one is very high? That list is exceedingly confusing. Why are tomato sauce is very high but salsa is little or none? There are many more examples, but those are the few off the top of my head.
My doctor recently told me that I need to be on this diet due to crystals seen in my urinalysis. I switched to almond milk and stopped eating beef about six months ago due to heart disease in my family. I wonder if the almond milk is part of the reason for my sudden crystal deposits. Could I maybe switch to rice or coconut milk? I don’t mind skim milk since that’s what I used to drink, but my daughter is vegan and has opened my eyes to the heinous practices of most dairy farms. Therefore, I refuse to buy their products. Anyway, sorry for the long post. Thank you for listening.
Hi Julie,
There are different oxalate values depending on the amount of the high concentration of the food, like tomato sauce and salsa. Don’t know why other sweeteners were not listed, but I can tell you that once these are processed there is no oxalate in any of them. So processing will negate the oxalate level of the stevia plant. I assume that the other ones are not listed bc they are pure chemicals and no plant was used.
Did you do a 24 hour test? Feel free to send it to me if so at jharris1019@gmail.com. Happy to look at it to see what your values are.
Soy is high and soy milk is not to be used. I will check the list and correct it. But remember too, it always depends on the concentration of the products. So perhaps one of those samples had less soy actually used than the other. Is your oxalate indeed high? You could use rice or coconut milk.
Hope this clears things up for now,
Jill
Thank you for the info, Jill. I have not seen my doctor again since my urinalysis. I noticed I had a script at the pharmacy and picked it up, which was cipro. I finally got a call from a nurse two days later saying that there were “crysyals” in my urine. I can only assume that she means calcium oxalate crystals. She then said to research the Mayo Clinic oxalate diet & named a few things on it that I should avoid.
I’m patiently waiting for my next appointment because I forgot to mention to my doc that I’ve been having urgency incontinence issues too. I’m thinking the two may be related. This doc is a bit of a flake though and now have little faith in him since he “forgot” to send my much needed 8 meds to the pharmacy when I first met with him. He did send one script, lol.
Anyway, I’m just sick of having to watch what I eat on this seemingly random diet. To a laymen, the items on these lists that have high oxalate value seem so random! I can’t be the first person who has said so. I’m also sick of flinching every time I go to the restroom because I think it’s going to hurt. The times that it hurts seems random too. I hate that I tried to eat healthy and now have a possible lifelong condition. A bit ridiculous.
Dear Julie,
I hear your frustration through your words and I understand just how warranted it it. I have helped many people who went on a “healthy” diet to lose weight and feel better, only to end up with stones. It is ridiculous! But good news, I can help. I have been doing this for years. You have two options. You may work with me privately or you may buy the kidney stone prevention course. Go to my website and look around. The diet is NOT random and I can sort everything out for you. jillharriscoaching.com
Take care and make sure you do a 24 hour urine collection please. Make the doc order you one.
Jill
Hi,
I read somewhere that white chocolate doesn’t have any oxalate since it is made from cocoa butter and milk and not from cocoa powder. Can you confirm whether this is true or not? Is white chocolate safe to eat for CaOX stone formers? If it does have oxalate , can you compare the oxalate levels between regular chocolate and white chocolate?
Thanks
Tom
Hi Tom,
White chocolate is safe, but remember it still has sugar and too much sugar is not good. So don’t go nuts on the white chocolate just bc it is low in oxalate. You can certainly use it as a safe treat here and there!
Jill
This is a terrific resource thanks. Can I ask, given lentil soup is listed as high, should I assume that lentils per se are high (I’ve seen them listed as low elsewhere).
Hi Claudia,
Yes, one can assume so. Since they are a healthy source of fiber, enjoy them in normal portions and once a week. Also, make sure your urine oxalate is indeed high before you limit healthy foods. Many times the issues is a low calcium diet that is causing the problems.
Best,
Jill
I had a 7cm stone went into the hospital had them blasted dr couldn’t give me a result they were sand & now I don’t know what to do now taking another X-ray never got a result from the stone have another one that is 3cm help
Hi Diane, Even sand can be analysed by commercial labs so if you collect any get that done. Here is a good article on how to pursue prevention. Regards, Fred Coe
I am very confused by some of this info. Please correct me (I am a repeat stone former who is trying to learn so I can modify my diet). I have always thought that potato is good because it contains potassium and that helps to counter the sodium in the food I eat. But now from this article I am seeing that potato is bad because of the oxalate? Is clam chowder OK to eat though because the calcium (from the milk) would bind with the potato’s oxalate in the stomach before reaching the kidneys? THANK YOU SO MUCH for your answer.
Hi Thomas, When anyone relies on one modality for prevention, the going gets too hard. Here is a complete pathway to be sure what treatment you need. Here is a special article on whether you even need a low oxalate diet. Assuming you have just routine calcium oxalate stone disease, here is a real treatment program. You can see it is based on low sodium, high calcium, moderate oxalate restriction, reduced sugar and high fluids. Apart from fluids and oxalate it is identical to the diet recommended for all Americans. This will obviate any need to worry about minor oxalate variations. Regards, Fred Coe
Dear scientific community,
There seems to be confusion regarding unit of measure within the oxalate content of foods by food type; specifically, the serving size.
For instance, an avocado is a fruit that varies in weight. Thus, one avocado may weigh 100 grams and another may weigh 200 grams. The oxalate content of foods by food type does not account for the varied weight.
In addition, a cup, teaspoon, tablespoon, and etc are highly subjective units of measurement. For instance, a cup to one person may mean 200 grams, yet to another person can mean 250 grams.
Therefore, please consider standardizing all measurement amounts to grams per item.
For example, Food Item: Avocados. Serving Size: 100 grams. Oxalate Category: Very High. Oxalate Value 19 mg. Food Item: Raspberries. Serving Size: 100 grams. Oxalate Category: Very High. Oxalate Value: 48 mg. By standardizing all units of measurement in grams, is it easier for people to compare to other items on the list?
Perhaps this will decisively clear up any misunderstandings regarding the varied weight and the unit of measurement.
Sincerely,
George Washington
Hi George, You are basically right. Food lists usually come in serving size units, as noted in the source tables. The 100 gram standard is rational but perhaps not so intuitive to the less scientifically inclined. Regards, Fred
Hi Dr. Coe, first let me thank you for making all of this information available in a readily understandable way – it is a real service. My situation is that at age 68 I’ve developed Ca Oxalate stone disease – currently free of stone s/p ESWL- in the setting of a habitually high fluid intake (>2.5 L/d seltzer), a 24hr U oxalate of 42 on an unrestricted diet, a modest dietary Ca reduction due to moderate lactose intolerance, a fondness for salt, and an ACE inhibitor. You’ve made clear the benefit of a reduced Oxalate diet and salt restriction which I’ve started, and also the benefit of of both Citrate and Calcium supplementation to limit Oxalate absorption (inasmuch as some folks are better absorbers than others) and reduce supersaturation. I’ve started 2 oz of lemon juice twice daily as a citrate supplement but wonder if taking a the readily available Ca Citrate supplements (Citracal 500mg) perhaps 1 with each meal would serve equally well if not better. Thanks so much.
Hi Stan, The citracal might work well giving you protection against oxalate and some citrate. Lemons are a nuisance, variable, and basically one can do better. But recheck the urine to be sure. Finally, low calcium is not good: you have bones. Find some calcium foods you can enjoy. Milk can be lactose free. Best, Fred Coe
What about flavored coffee, such as Hazlenut
Hi Corrado, Not a problem. Fred
Approximately one year ago I started following a primarily plant and fish based diet to improve my general health and lose weight. I have been very dedicated to it and have lost 44 pounds to date. I regularly consumed a lot of spinach, nuts, seeds, beans, broccoli, carrots, sweet potatoes, dark chocolate, etc… Around the same time I also cut out sugar, dairy (except for some Greek yogurt), and most grains because I was worried about the inflammatory effects on the body. I supplement calcium with a chewable (Calcet Chocolate Fudge Creamy Bites Calcium Citrate with Vitimin D3) due to surgical related nerve damage that makes swallowing pills difficult. I was not faithful to my calcium supplement, which I very much regret. I have recently been diagnosed with kidney stones and asked to follow a low oxalate diet. Can I continue to use my current calcium supplement since cocoa powder is listed as an ingredient? I have a good supply and hate to waste it, but will if I must. I also have a vegan B-12 EZ melt supplement that I am unsure of the oxalate content, and Benefiber fiber supplement that I can find no information regarding oxalate content. The low oxalate diet is a lot for me to take in all at once, but I want to do this properly and maintain good general health. Thank you in advance for your help, and for this article and it’s links, which is the best I have found in my search for information.
Sincerely,
Nancy
Dear Nancy,
Thanks for writing. You can certainly use the supplement. Please make sure you get a 24-hour urine collection to see exactly why you made the stone if you have not already done so. For many of us, it is a low calcium diet in combinate with eating VERY high oxalate foods that can contribute to stones.
Jill
Thanks Dr. Coe
Hi Dr. Coe,
I have been taking a collagen powder (mixed in water, sometimes once a day). I just read that this might not be good for stone formers. What is your take on collagen supplements?
Hi Jeanette, Collagen contains hydroxyproline that the liver converts to oxalate, so one should be sure it is not raising urine oxalate levels. I would stop it. But be sure you have properly evaluated your stone risks and are doing rational stone prevention. Regards, Fred Coe
Hello,
I have been eating healthy, but all wrong for a person with these types of Kidney stones. Thank you for your article. I believe you said there was a way to get oxalate information about particular food items – where can I find this information? Almonds are high in oxalates, so is Almond milk by default high in oxalates, or is the process of making it diminish some of the oxalates? The Almond milk I buy is higher in calcium than the milk, and I would like to keep counting on it for my calcium intake. Thanks for any information!
Hi Deborah, Here is my best response. Be sure you know what is causing your stones and act to reverse those things. For example, urine oxalate may have nothing to do with your particular stones. Here is my best on the way to do this. Details of diet oxalate may not even matter to you. Regards, Fred Coe
Thank you very much for your incredibly helpful article. I am currently 31 and have been vegan for 13 years; for the last two years I have had more than five kidney stones. I was wondering what you recommend for someone like me; that is, how can I maintain my vegan lifestyle while also lowering my risk of kidney stones?
Thanks again!
Chad-
I takes private consultation to help- which I do. I have helped many began safely lower their oxlates without giving up their entire diet. You can email me if you decide to get help with your diet- jharris1019@gmail.com
Best,
Jill
I am trying to find out if hemp seeds are high in oxalic acid or more similar to linseeds, as this is a source of protein as a vegetarian. Thanks for the great website. Tony
Tony,
To the best of my knowledge, no. I have people drinking hemp seed milk to get calcium and they are continuing in keeping their oxalate levels down.
Best, Jill
Is almond milk high in oxalate?
Hi Taurel,
Since almonds are high, we can safely assume that it is on the higher side. Use fortified coconut milk or flax milk.
Thanks for writing,
Jill
Thank you for this article. Very informative for calcium and oxalate mix. I lost a kidney due to massive calcium ^ oxalate stone. Now a further restriction in my case. i need low salicylates due to mild allergy. Lately an increase in citrates required due to low citrate level in urine which runs the risk of calcium stones? between a rock and a hard place….
Hi Lex, Massive calcium oxalate stones are uncommon. Do you have a very high urine oxalate level?? Have you been fully evaluated? Take a look. With only one kidney urine citrate can be low from reduced kidney function. As for citrate, it is not a cause of calcium oxalate stones and has been found effective for prevention in trials. Regards, Fred Coe
thank you. that helped a lot. I lost the kidney in 1979.
hypercalcuria at the time. Now under control. recently oxalates have risen to above the recommended range. citrate now well below . taking Ural to raise the citrate using 1 sachet per day.
using diet to reduce oxalates over time. . but the dieticians recommedations vary somewhat from this article and food lists… one additional question though . is the oxalate level in urine an ad hoc indicator related to what i ate the 24 hours prior or a longterm imeasurement.
working my way through it all.
Hi Lex, Oxalate is absorbed promptly so urine values tend to vary by the day. The diet change to reduce oxalate is high calcium – 1000 mg or so from food timed so the calcium comes with the main meals. The diet list on this site is probably the best available as it was curated by a major investigator in the field – not me. To keep urine calcium in bounds with so much intake, keep diet sodium below 2000 mg daily, preferably lower. Regards, Fred Coe
Thank you for your informative, thorough and extremely helpful info. So sad to discover nuts, nut butters, beans and tea are high oxalate foods. What about pumpkin puree (organic, canned), extra virgin olive oil and coconut oil? Would love your take on those. Thanks!
Hi Kim, before sorrow ask if you need a low oxalate diet. See where you fit in, and then perhaps your mood will shine brighter. Regards, Fred Coe
Thank you for posting this information. I just got my 24-hour urine levels back; I don’t need citrate, my level is 684 mg/day. But despite cutting out spinach I am excreting 88 mg/day of oxalate. I don’t drink milk due to allergy/intolerance, so I need to look at increasing calcium intake. Interesting information about “stone formers are different”. I will be consulting with a sub specialist urologist at Kaiser in San Diego to discuss my results soon.
Hi Stanley, Low calcium diet favors oxalate absorption and is the probable reason for the high urine levels. Regards, Fred Coe
Why do you say avocados are high in oxalate, whereas every other site and paper I’ve seen say they are low?
Hi Gerry,
The list from Harvard (not Dr. Coe and I) was compiled by a leading expert in the field of oxalate measurement. I will say this, although they are listed as high, all my patients eat them without a problem. They easily fit into a low oxalate life style. Never just look at the adjective that describes the food. Look at the portion size and the amount of oxalate listed. That will tell you if it is acceptable on a low oxalate diet. And remember, most don’t even need a low oxalate diet, most of us need to up our calcium consumption.
Hope this helps,
Jill
Thanks but the text of the article above would lead many to exclude avocados:
In fact, the latest papers define avocado as a very low oxalate food. Here is a 2015 paper that find Perseus Americana (avocado) rates low:
Screening of Some Indigenous Wild Fruits for Anti-Nutritional Factors
Hi Gerry,
You must realize that all of the foods will have differing amounts of oxalate when analyzed due to the different growing conditions they each come from. Again, they may be listed as “high” on the Harvard list, but we tell our patients to eat them and we teach them how to safely incorporate the higher oxalate products into their life.
Best,
Jill
We need to add sesame seeds to the list. They are VERY HIGH in oxalates. It’s very important for people who eat sushi often…
Hi Oksana,
They are high but I am not worried too much on what comes on a sushi roll. There is not enough to make a difference, especially if one is getting their recommended amount of daily calcium.
Thanks for writing,
Jill
I did react a lot to sushi, before I figured out that sesame seeds are extremely high. I order sushi without sesame now and do not react. They are much higher than spinach, etc.
Dear Oksana,
I am not questioning your reactions, I am just saying for the average stone former, I am not worried about sesame seeds on sushi increasing their risk of stone formation.
j
Oksana,
Stopping intake of calcium, from food or supplement will def lead to an increased oxalate level. You are at risk of increased stone and bone issues. Please reconsider bringing foods that contain calcium or supplements.
Thanks for writing-
Jill
It’s strange to see millet and Brussel sprouts on the “high oxalate” list… I react to high oxalate foods (pain)… I discovered that potatoes are high before they were even on any of the lists. But I do not react to millet and Brussel sprouts at all.
Also… I am in low oxalate diet since 2008 (for pain). Even though a doctor told me about it, other doctors look at me as if I have two heads when I mention this diet (I saw rheumatologists, primary care providers, etc.). So I do not mention it anymore. I measured oxalate levels when I was in another country, while on the low oxalate diet. They were > 90 mg (the upper limit normal is around 40). What specialist should I see next? What CAN they do for me bedsides asking to follow the diet I already on?
Hi Oksana,
Are you getting enough calcium into your diet to help lessen the amount of oxalate you absorb? Have you done a 24 hour urine collection?
Jill
That measurement was based on the 24-hour test. I did take calcium citrate in 2008-2009, but it did not make much difference. I am also taking vitamin D (as suggested by a doctor) and it’s not recommended to take it with too much calcium, so I stopped take my calcium.
Hi,
Could you please mention Thanksgiving food oxalate levels? Raw cranberries vs. cranberry sauce, pumpkin pie, and green bean casserole? Also are their different types of stuffing that are more acceptable as to the base content of the bread for stuffing? We are going to two Thanksgiving dinners in four days and will also be eating leftovers. This is a great website to prevent kidney stones. Due to this diet I have been stone free for 19 months. 🙂 Thank you.
Judy
Hi Judy,
Thanksgiving tends to be a higher oxalate day. Please eat normal portions of foods and you will be fine. It is only unhealthy when we stuff ourselves. Little bit of everything and you will be fine.
Enjoy!
Jill
Thank you Jill. I am very grateful for finding this website and receiving guidance from Dr. Coe in the past. I hope you both have a very nice Thanksgiving Day.
Judy
After many years of looking for solutions for calcium oxalate stones, my new urologists had me do a 24 hr urine sample and discovered that my urine oxalates were off the charts. So, after many years of looking for answers, I was put on a low oxalate diet. The last several years I have been following a plant-based diet pretty well thinking that I was eating a healthy diet. I ate minimal animal products but substantial amounts of nuts, seeds, fresh ground nut butters, brown rice, a variety of beans, and a good share of spinach. Until now, my intention was to mover closer and closer to a vegan diet. So my question is … is it possible to be a vegan on a low oxalate diet? Thinking about cutting out dairy, cheese, meats, etc but also reducing or eliminating other high oxalate foods, for example, nuts, seeds, and consuming other things such as some grains in moderation to get dietary oxalates below 100 mg/d, seems nearly impossible. I have been consuming peas as a source of protein but after eliminating nuts and seeds, milk and meats, how do I get the protein in my diet? What about other sources of healthy fats? I would like to stay away from animal products as much as possible but it just doesn’t seem reasonable after eliminating the plant based sources of protein and fats. Any help would be appreciated.
Hi Pat, Vegan diet for stone formers is not easy. This is one Jill Harris might be best for. I will ask her. Regards, Fred Coe
Hi Pat,
I have worked with vegans, and I will tell you that it is tough to get all your nutrients and keep oxalates down. It is possible, but working one on one with me or someone like me if you can find that is what is needed. A simple reply will not suffice.
It does take some time to meal plan and figure out how you are going to be able to get everything you need for optimal health, but minimize stone risk.
Let me know if I can be of assistance-
Jill
I would agree with Jill. I have some patients like you and could not solve their problems without recourse to our medical nutritionist. Fred Coe
Ive talked with a few nutritionist but none have been helpful in answering questions about oxalate, alternative protein sources, vegan, etc. Any suggestions on what (who) I should be looking for in my area?
Hi Pat,
Unfortunately, most nutritionists and dieticians do not know about oxalate. I am happy to help. I offer phone consultations and The Kidney Stone Prevention Course. You can find both options on my website at jillharriscoaching.com. I can help you if you like.
Take Care,
Jill
I have another question about the role of dietary calcium when following a low-oxalate diet. I see in the information above that dietary calcium should be about 1000 mg/d and oxalates around 50 mg/d. How does calcium supplements fit into the picture? My docs tell me “dont take calcium!” Is there an balance between calcium, magnesium, and vitamin D? The more I listen to my doctors and the more I read, the more confused I get. Thanks for the tips.
How often are the oxalate food lists updated?
Where can I get the Harvard list?
Hi Pat, The high diet calcium can really help lower urine oxalate. I never propose 50 mg oxalate diet; usually below 200 mg/d is fine. Low calcium diet is not an acceptable treatment – you have a skeleton and urine oxalate will be hard to control. Trial data are against it. If you use supplements – a second choice to real food- they must time with the meals that contain oxalate or will be without effect to lower oxalate. Magnesium is usually no problem and vitamin D is measured to determine need. Regards, Fred Coe
I had a 24/hr urine done and my results were oxalate urine 46, calcium urine 7.3mg/d, calcium urine mg/day 208, and uric acid 966. If you are on a low oxalate diet will it help with fibromyalgia (inflammation)?
Hi Rebecca, the oxalate – if mg/day – is quite high. The urine is high normal. I know of no reliable data that low oxalate diet affects inflammation. Claims I have seen on the web seem without a basis. But if you are a stone former, you need to look much more comprehensively. Take a look. Regards, Fred Coe
very informative, narrative article. Thank you for putting all that source information together and sending along to us. Very helpful!
Great site; appreciate your thoughtful and thorough approach! A few items I could not find an oxalate level for:
– steel cut oats (prepared as a breakfast cereal)
– coconuts / coconut milk
– red peppers (assume they will be low like other peppers)
– black beans (assume they will be higher like other beans)
– quinoa
Thanks
Hi John,
My patients do drink coconut milk as I do believe they are lower in oxalate. Everything I have read points to low, and my patients do keep their urine oxalate in the green zone while using it. Quiona we do not have solid numbers for and when that is the case I go by this: eat the food in normal (emphasis on the word normal) portion sizes, once or twice a week and you will be fine. Your assumptions on the other foods are spot on.
Thanks for writing-
Jill
And how about the oatmeal? I keep finding conflicting information on it. Thank you for your article!
Hi Justin,
Use one list, we use the one by Harvard which you can find on the site. We use it because, along with our other dietary advice, our patients lower their urinary oxalate. It is low, my patients eat it. Enjoy.
Jill
Thank you, but don’t discuss spices at all. Are they Okay because of the quantity used is minimal?
Hi Janice,
Harvard does not include spices on their list, but yes, probably bc the amount is so minimal.
Jill
When I moved from the northeast to the southeast (the kidney stone capital of the world) I started to develop one calcium oxalate stone after another- largely in part to dietary changes. In addition to watching my diet, I started taking Theralith-XR
(made by Theralogix and available without a prescription) and have not had any further problems. Theralith-XR is a combination of low dose Vit B6, Magnesium and Potassium Citrate and Magnesium Oxide. It’s not going to help if your stones are not oxalate in nature. You still have to avoid dietary indiscretion!!
“Slice of bread” is helpful, but still not very specific. I’m hoping to eat one slice of sprouted grain, cloudless bread daily, with @ 2 T of seed butter I make of sunflower and pumpkin seeds (only). I’m guessing that this would be between 10 and 15 mg?
Discovering my stone status has been traumatic, as I also just learned I’ve got high cholesterol (eggs!) and hypothyroidism (which means no cole crops like most of the tasty vegetables on the “safe stone list”). Eating dairy is also problematic because of the cholesterol issue. I’m floundering. I sort of want some sort of Ill American Lembas. Oh well, back to the ol’ yogurt… 😟
Hi Kara,
Harvard did not measure every type of bread, so this is what we have. My patients are told to have a slice or two of bread, and not to worry. If you have conflicting diets, it is best to work with someone who can help you sort it all out. If you need assistance, reach out to me. You can find me here: jharris1019@gmail.com.
Thanks for writing- Jill
Hello, The information on your site seems to be excellent, and I’ve done a lot of research.
However, the program you are using to display this site doesn’t print the text in either Internet Explorer 11 or Safari 5.0.
I would very much like to receive all the information on this site if you could please email it to me in PDF format at daprilsunshine@gmail.com. Also If that isn’t possible, please tell me what browser to use to view it correctly and print it myself.
Thank you, Jana Beren
Hi, I just viewed the site on IE and it looked fine. Printing will pick up the links but otherwise seems fine, too. Chrome is native for the site. It is in WP. Fred
I am recovering from surgery on my left side for the removal of kidney stones. I have been informed that I have a unique physiology of having two ureters on both kidneys. Left side had a stone in each ureter. I am grateful to have found your site and all the information is the first that I have found that details that this situation is more manageable than I have been led to believe. I am wondering if you have a protocol to follow on eliminating the stones on the right side? My surgeon is recommending surgery on the right side soon and I am eager to do anything to prevent another surgery. Thank you University of Chicago, Dr. Coe, Jill and all who have contributed to this great effort!
Anne
Hi Anne, double ureters are a problem and not so rare. The urology will have to be skilled and I am sure that will be the case. As for prevention, here is my best on it. Regards, Fred Coe
I was told that the most important thing. besides the big oxalate foods, was my sodium intake and animal protein intake. So trying to eat dairy, such as cheese and cottage cheese, as well as eggs are a problem. Confused on how to get all the factors to work together..any suggestions.
Hi Julie,
The most important things are low sodium, normal calcium, avoidance of the highest oxalate foods. You can get plenty of low sodium, high calcium foods if you hunt for them. Good Karma, flax milk is a nice source of that and low sodium cottage cheese and yogurts. Hopefully, you have gotten testing to see what your issues are and can go from there. If you eat normal portions of these things it will not bother your protein. Keep your meat portions to less than 6 ounces per day and you can eat the cottage cheese and yogurts.
Go here for more info:
Hope this helps,
Jill
My problem is getting enough calcium, I’m very sensitive to milk proteins, calcium supplements seem to do more harm than good. I would love to see a list of non-dairy, low oxalate, low salicylate foods. My diet is limited to begin, due to severe salicylates sensitivity.
Hi Page,
Wondering if flax milk would bother you or coconut milk. Both low oxalate but a good source of calcium. Try and let me know-
Jill
Hello,
I have Medullary Sponge Kidney and have been getting stones since I was 15. Until now a diet wasn’t suggested to me (I think primarily becasue my issue is more due to the structure of my kidneys.) However, my stones are coming more regularly now which is both painful and frustrating for an active young person. I am beginning a low oxalate diet and doing a Theralith XR supplement to try to see if it will help make my stones less frequent. I’m wondering what kinds of bread are acceptable becasue it seems like most kinds are not? Is wheat in general bad? Would gluten free options be a better option or not? Thanks!
Dear Jennie,
I hate that you are getting more of them. You have been suffering much too long. I suggest you take our course on kidney stone prevention. You can find it here: jillharriscoaching.com/course. As far as the bread, you can safely incorporate healthy grains into your diet if you eat NORMAL portions of foods. The problem is that we do not eat at all normally. Gluten will not make a difference, and typically gluten-free options can be unhealthy as these products typically have more added sodium and sugar to make up for the lack of taste and texture gluten provides.
If you want bread, no more than two pieces per day. Make it high in fiber, low in sugar and sodium.
Write me at jharris1019@gmail.com if I can help more. I don’t want you to suffer anymore.
Jill
Two different websites have conflicting information… which one do I take in??
Hi Emily,
Truly confusing, isn’t it. We use the list by Harvard as we trust the research and with our other advice and experience, our patients do indeed lower their urine oxalate. Please stick to one list, stop searching, and you will be fine. We do recommend the list in the article
Even more important, is making sure you are getting enough calcium into your diet. Most people aren’t and that is more of the problem than fruits and veggies. Do a urine collection to see if your urine oxalate is high, if yes, take away the highest oxalate foods and get your calcium and lower sodium. And of course, get in your fluids.
Hope this helps,
Jill
I was also frustrated by websites contradicting each other. This list also contradicts itself though (soy milk for example listed as “very high” then further down as “low”). I don’t drink soy milk, but I’m hesitant to trust everything else is correct after noticing that.
Hi Mason, Website oxalate lists are very at odds. Ours originated at Harvard and has been curated by Dr Ross Holmes, a nationally recognized authority on food oxalate. He knows about the soy problem, I believe and is the process of checking for new references and trying to reconcile this and other inconsistencies. Regards, Fred Coe
Hi Mason,
Understand your concern. We are aware of this as Dr. Coe said. Please know that soy and soy products are high in oxalate.
Best,
Jill
With all the training you have in nutrition, you should know that calcium from dairy is not a good form of calcium. Dairy product leach calcium from your system. No one should be drinking or eating dairy.
Hi Naomi, I believe you have just discarded decades of calcium balance studies; Milk calcium is absorbed and goes into bone. I am afraid a lot of measurement contradicts what you believe is true. Regards, Fred Coe
Why is there no mention that high animal protein intake increases urinary uric acid which helps urinary oxalate to form stones? Is that no longer a risk factor?
Hi Gus, Well, I guess half and half. I started this nearly 45 years ago, and there is the allopurinol trial referred to in the relevant article. So yes, it seems to matter. But we do not know how it works, and lacking such despite a good trial we hesitate to say much. Great question! Regards, Fred Coe
I find this information on high oxalate foods fasinating. No kidney stones yet, but recently my Calcium levels have increased, I’m 62 y/o. I want a dietary answer to resolve this before my kidneys are affected. I was a big chocolate eater, ate many foods on the high oxalate list.
Could decreasing oxalate foods help to decrease my calcium blood level? Also found to have diffuse degenerative changes in the lumbar spine.
Hi Susan, If you mean your serum calcium level has risen above normal, oxalate is meaningless. A rising blood calcium level in a 62 year woman is probably primary hyperparathyroidism and needs proper evaluation and cure. Your personal physician no doubt already knows this, and I would let him/her attend to the matter. This is not something one can do for oneself. Regards, Fred Coe
Why not take calcium pills with each meal, with the total being 1000mg or less (depending on dairy intake. It might be a solution for the lactose intolerants among us.
Hi Arthur, It can be done, and will be fine if taken with main meals. But food calcium is probably – no trials – a bit safer as calcium is released from other food constituents a bit more slowly and probably – no trials – absorbed over a longer time. Regards, Fred Coe
Just curious, you’ve said animal protein is ok, but is bone broth ok?(cooked several hours in an instant pot so that there is gelatin and then quickly frozen to keep histamines as low as possible)
Hi Shelly, Bone broth has a lot of DNA and RNA and cartilage so it can raise urine uric acid and oxalate. Perhaps you might check your 24 hour urine after a day of eating it to assess the results. Regards, Fred Coe
I recently had kidney stones removed through lipsotriptsy in both kidneys. I have Hashimoto’s and do not eat dairy, grains gluten or nightshades. This has helped to reduce inflammation. It appears that go to vegetables I eat are high in oxalates.; sweet potatoes, kale, broccoli, avocado and celery (juice). I am at a loss of what to eat. I thought the calcium oxylate stones I had may have been from Vitamin D3 without vitamin K2. I now supplement with K2.
Hi Christine,
You can still eat plenty of items but you do need to get your calcium somehow. I suggest getting some help with a qualified health professional. Also, make sure you get a 24-hour urine collection done so you can see what your urine chemistries tell you.
If you have trouble finding someone to help you can write me at jharris1019@gmail.com–
Jill
I have a 11mm stone in my kidney with blood in my urine. My urologist doesn’t seem too concerned about it since he said we can discuss this at my May appointment. So, this time, I am preparing myself with knowledge about kidney stones and prevention. I am lactose intolerant so I don’t handle dairy products easily. What can I do to supplement this area as I read it is important to get my calcium somewhere.
Thank you,
Patrick
Hi Patrick, given the stone you need to prevent more. Here is reasonable approach. See if it works for you. regards, Fred Coe
Hi Patrick,
You can get plenty of calcium from non dairy sources like coconut and flax milk. Coconut yoghurt (watch sugar on these products and go for the lowest amount of added sugar).
Google non dairy sources of calcium and you can get an idea. If you need to lower oxalate (you will know this by doing a urine collection) do NOT pick food sources that may have calcium but too much oxalate (spinach is an example of this).
Thanks for writing,
Jill
I am getting to the point where I don’t know what to eat to be honest. I have Hashimoto’s SIBO, Candida overgrowth (which has improved and histamine issues as well as a high oxalic acid reading on my Organic Acid Test. Have been dairy free and gluten free for over a year now. What I can eat on my SIBO and Candida diet sheet is forbidden on my oxalate list. I have constant anxiety, nausea and aching joints the last few days. I have the odd day where those symptoms subside and I feel OK and then I am back down again and I just don’t know why. Could it be something I have eaten? I have been up and down now for over 2yrs and I just don’t know what to do anymore. My FD recently changed my mag to a Calcium/Mag (citrate and malate formula) which she wants me to take 2 at bedtime to help bind any oxalates I might have. I have read about “oxalate dumping”. Is that the same as having die-off symptoms with Candida and SIBO. I am just so confused; have read so much and can’t seem to get on the right track with any of it
Hi Jennie, Perhaps you are locked into a confusion situation. Are you sure a strict low oxalate diet matters for you? Here is an article that might really help. Let me know, Regards, Fred Coe
Jenny’s story is basically my story! I don’t know what to eat at this point I have a genetic issue re oxalates but still not clear on this after reading this informative article. Also have leaky gut, genetic issue re tyramine and gluten sensitivity. Food sensitivity test indicated a lot of foods to avoid. Haven’t been tested for Sibo yet. Would love to get further testing done re oxalate issue to know what type of issue I’m dealing with. Any suggestions would be appreciated. Thank you !
Hi Anita, Before immersing yourself in the problems of low oxalate diet, are you a stone former? Is your urine oxalate above normal? Are your stones calcium oxalate? In general oxalate is inconsequential unless the above questions are all yes. Regards, Fred Coe
I have a question regarding avocado oil…I have changed from olive oil to avocado oil, and now I see avocados are not good, how about the oil?
Hi Nancy, being a polar molecule, oxalate cannot dissolve in any oil. So you are safe. Regards, Fred Coe